Alleviant - Compliance Manager
Location: South Dakota
Description: Navigant Consulting is looking of Alleviant - Compliance Manager right now, this vacancy will be placed in South Dakota. More details about this vacancy opportunity please read the description below. Alleviant is powered by Navigant Healthcare, a Navigant Consulting practice with more than 600 seasoned consulting professionals and industry thought leaders who assist health systems, physician! practice groups, and payers in designing, developing and implementing integrated solutions that create high-performing healthcare organizations.
Alleviant, LLC offers a wide range of billing and collections services to health systems that employ physicians and independent physician organizations. Alleviant assumes responsibility for effectively delivering central billing office operations including coding and charge entry, bill processing, claims submission, payment posting, denial management, accounts receivable follow-up, patient collections and business analytics. Alleviant also offers a full range of hospital/surgery center, insurance/payer and other credentialing services. With processing centers in South Dakota, Alleviant offers access to both top industry thought leaders and a reliable, cost-efficient workforce. For more information go to www.alleviant.com .
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Position Overview
This position leads all efforts within the Alleviant practice r! elated to organization compliance, beginning with the ongoing ! deployment and daily application of the organization’s compliance plan across the business unit. With limited supervision from the Chief Compliance Officer, this person identifies, investigates and resolves all compliance issues relating to the delivery of Alleviant services, including, but not limited to, coding, billing, documentation, reimbursement activities and privacy of patient data. As appropriate, heads special compliance investigations in coding, billing and reimbursement including formal and informal audits of process, delivery of services, and/or technology enabling delivery of services.
Essential Job Functions
Owns application of the compliance plan and it’s use across the organization Chairs the organization’s compliance committee and leads regularly scheduled meetings of this committee to address compliance related updates and/or concerns Reviews, assesses, studies, and analyzes the overall coding, billing, documentation and reimbursement system! for potential compliance problems and non-compliant activities. Designs and conducts formal audits of specific aspects of the overall coding, billing and reimbursement system. Reviews and studies all information published by HCFA and the OIG via the Federal Register, fraud alerts, OIG advisory opinions, and other publications relative to coding, billing and reimbursement compliance. Additional Responsibilities
Reviews and studies all information from third party payers relative to claims filing, coding, and the adjudication process. Uses a systematic approach for the identification and resolution of complex compliance problems. Works with health information management, patient accounts, information systems and other medical center personnel to solve and implement solutions to maintain a proper compliance stance. Works with the Chief Compliance Officer relative to difficult coding, billing and reimbursement compliance issues. Works with contract management personnel in ! the review of contracts and other reimbursement or payment arrangements! . Works with the Chief Compliance Officer in the development and ongoing activities involved in the baseline and periodic compliance audits. Conducts informal audits on various aspects of the coding, billing, documentation and reimbursement system. Monitor corrective actions for audit review findings. Provides training sessions for both general and specific problem resolution in the coding, billing and reimbursement area. Writes and assists others in writing various types of policies and procedures in order to maintain proper compliance. Special projects, as assigned.
Requirements
Experience in audit role required. Experience in physician coding required. Bachelor's degree with 5+ years experience required or equivalent combination of education and experience sufficient to successfully perform the job. Certification in one of the following preferred: Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Co! der (CPC). Demonstrated analytical skills. Demonstrated ability to review analytical, data and audit findings to identify coding trends and risk areas. Demonstrated ability to work independently with minimal supervision. Demonstrated ability to constructively and sensitively provide feedback to applicable parties regarding federal and state coding, medical documentation and compliance guidelines, audit results and risk areas. Ability to work with and maintain confidentiality of physician, patient, patient account, and personnel data. Demonstrated ability to effectively work within a team environment, using excellent written, verbal and presentation skills to share audit findings, risk areas and compliance issues. Limited travel, typically in-state, may be required.
The company offers competitive compensation packages including an incentive compensation plan, comprehensive medical/dental/life insurance, 401(k) and employee stock purchase plans.
Neither Alleviant! LLC., nor its parent Navigant Inc., will accept unsolicited resumes th! rough or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Navigant and Navigant will not be obligated to pay a placement fee.
EOE M/F/D/V/SO
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Navigant Consulting.
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This vacancy starts available on: Wed, 17 Apr 2013 09:53:35 GMT